| Background:Malignant tumor is a difficult problem threatening human health.Although the treatment of malignant tumor has been diversified in recent years,a large number of patients have benefited from different treatments.However,the prognosis of malignant tumors is still poor due to their biological characteristics.Lung cancer is one of the common malignant tumors and the highest mortality rate in the world.According to the latest report issued by the National Cancer Center,the number of new cases of lung cancer in China was about 787 thousand and the number of deaths was about 631 thousand.Among them,SCLC accounts for about 15% of the total number of lung cancer.Because of the high degree of malignancy and the biological characteristics of metastasis,the prognosis is very poor.Once there is brain metastasis,it means that the disease is advanced.How to choose the appropriate treatment for this kind of patients and how to accurately judge the prognosis is a problem that the clinical work has been exploring all the time.Objective:To study the prognostic factors affecting the survival time of patients with brain metastasis of small cell lung cancer undergoing brain radiotherapy.Methods:In this study,69 patients with brain metastasis of small cell lung cancer and brain radiotherapy were diagnosed by histopathology and brain imaging in the second Hospital of Jilin University from January 2015 to January 2020.SPSS(25.0)software package was used for statistical analysis,Application of ROC to determine the optimal cut-off value of inflammatory composite index(NLR、PLR、 PNI and SII),Kaplan-Meier method was used to calculate the survival time and 1 year and 2 year survival rate of each group,And draw the survival curve.Log-rank test whether there was significant difference in survival time between factors(P<0.05),A multivariate regression analysis was carried out by adding factors with significant difference in prognosis to the COX proportional risk model,Find independent factors that affect prognosis(P<0.05).Results:1.The follow-up time of 1.69 patients was up to 20 December 2020,2surviving patients(2.9%),67 deaths(97.1%),For a minimum of three months,For a maximum of 33 months,The median survival time was 11 months,The 1-year survival rate was 36.2% and the 2-year survival rate was 7.7%.2.Univariate analysis: the results of univariate analysis showed that the KPS score was low,the non-brain oligometastasis,the maximum diameter of brain metastases,the less than four chemotherapy cycle after brain radiotherapy,the choice of WBRT mode,high NLR、PLR value and low PNI value had adverse effects on the survival and prognosis of small cell lung cancer after brain metastasis,And has statistical significance(P<0.05).Six factors,such as sex,age,NSE level,smoking or not,chemotherapy before brain radiotherapy,and control of primary lung lesions,had no effect on the survival time of patients(P>0.05).3.COX multivariate analysis: KPS score,brain oligometastasis,number of chemotherapy cycles after brain radiotherapy,choice of radiotherapy mode,value of PNI and SII were independent prognostic factors affecting survival(P<0.05).Conclusions:1.The survival time of SCLC patients with brain metastasis is longer with KPS score≥80,brain oligometastasis,brain metastasis≤20mm,choice WBRT+SIB radiotherapy,adequate cycle chemotherapy after radiotherapy,NLR<3.21,PLR<204.07,PNI≥48.45 and SII<739.57.2.KPS score,brain oligometastasis,number of chemotherapy cycles after brain radiotherapy,radiotherapy mode,PNI and SII value are independent prognostic factors.3.Active treatment of patients with SCLC brain metastasis can benefit survival if conditions permit. |
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